iLoveBenefits: Industry News Blog

1 in 3 Adults Have Not Planned for Long-Term Care Needs

The Associated Press recently published their 2016 Long-Term Care Poll on attitudes and preparedness for long-term care. Here are some key findings from the report:

·         4 in 10 American adults over age 40 expect to rely on Medicare to pay for their long-term care needs.

·         One-third say they have done no planning at all for their own long-term care needs.

·         More than three quarters would prefer to receive care for themselves in their own home.

·         67% would prefer for their loved ones to receive care in a home setting.

·         Half of older Americans support government-administered long-term care insurance programs.

·         72% support state paid family leave programs to help Americans providing care to a loved one.

Source: Associated Press, June 1, 2016

What are you doing to prepare for retiree health care?

According to a recent study by Ameriprise Financial:

  • 86% of baby boomers express concern about the affordability of health care in retirement.
  • 19% surveyed say they have taken one or more steps to prepare.
  • 26% have reviewed their options but have taken no action.
  • 40% have thought about it but haven’t looked into it in detail.
  • 15% of respondents haven’t begun to consider how they will cover health care costs in retirement.

Note: Data from more than 1,000 employed baby boomers ages 50-64 who are preparing for retirement with at least $100,000 in investable assets, asked these individuals about their attitudes toward health, health care costs and the impact each may have in retirement.

Source: Business Wire

Providing a written plan. . . of care

Most cancer patients enter survivorship with little direction from oncologists or primary care providers, according to a national survey.

Two-thirds of 1,130 oncologists said they always or almost always discuss survivorship with patients, but only a third told patients where to seek cancer-related or other care. Fewer than 5% of oncology respondents provided patients with a written plan for survivorship care.

Read more here: Of 1,020 primary care providers surveyed, 12% reported regular discussions about recommendations for survivorship care or provider responsibility, as reported online in the Journal of Clinical Oncology.

Most who follow me know that I have a vision for how health care will evolve. The next two big things that need to occur are transparency of pricing – what patients are expected to pay for the services they receive – estimates if not actual prices based on the insurance they have and the current terms of that insurance. And not necessarily in this order a plan of care.

Let me explain what is meant by a plan of care. It goes well beyond the story in the Journal of Clincal Oncology. That is just one example.

It is a plan that every person should have. It is the equivalent of a financial plan. It is something that the patient has the key to access, a portal and a document through which to view and understand their medical condition and the actions that they or their caregivers need to take to optimize the outcomes that patient is seeking. It is something that the patient enables others including their providers and caregives to view and to add to with their special knowledge and information. It spans every episode of care. Whether that is a prevention episode, a wellness episode, an acute episode, a chronic episode, even a secondary prevention episode.

It enables hospital discharge instructions to be cleanly handed off to family caregivers, rehabilitation caregivers, other physcians or nurses caring for the patient. It enables the primary care physician to view what all other parts of the health system are contributing to the health of the patient. It provides a means of communicating with the patient while in the office and to be sure that the instructions are clear when they leave the office. It helps turn the office visit into a counselling session rather than simply a visit and script.

It links physician to nurse, pharmacy to physician, hospital to rehab or nursing facility. It helps turn siloed health care services into a system of organized and informed health processes focused on the patient.

How long do patients remain in hospice care

Lenths of Stay for Patients Receiving Hospice Care in The U.S. in 2012

<7 Days – 35.5%
8-29 Days -27.0%
30-89 Days – 17.4%
90-179 Days – 8.8%
180+ Days -11.5%

Source: Managed Care, March 2014
Data Souce: National Hospice and Palliative Care Organization: NHPCO’s Facts and Figures, 2013

Top 25 Most Expensive Markets for Long-Term Care Coverage

Top 25 Most Expensive Markets for Long-Term Care Coverage


Nursing Home Private Room Annual Rate

Bridgeport-Stamford-Norwalk, CT


Anchorage, AK


New York-Northern New Jersey-Long Island, NY-NJ


Poughkeepsie-Newburgh-Middletown, NY


Hartford, CT


Boston-Worcester-Lawrence, MA


Rochester, NY


San Diego, CA


Seattle-Tacoma-Bremerton, WA


San Francisco-Oakland-San Jose, CA


Philadelphia-Wilmington-Atlantic City, PA-NJ-DE


San Jose-Sunnyvale-Santa Clara, CA


Albany-Schenectady-Troy, NY


Portland, ME


Honolulu, HI


Washington-Baltimore, DC-MD


Sacramento-Yolo, CA


Boise, ID


Milwaukee-Racine, WI


Manchester-Nashua, NH


Miami-Fort Lauderdale, FL


Buffalo-Niagara Falls, NY


Los Angeles-Riverside-Orange County, CA


Detroit-Ann Arbor-Flint, MI


Portland-Salem, OR


Source: New York Life Insurance Company

What most of need . . . a little more attention . . . especially as we age

Loneliness, social isolation raise risk of early death
Older patients who reported being lonely had a higher risk of dying over the six-year study period than those who did not report loneliness, according to new research. Another study revealed that heart disease patients who lived alone had higher risk of cardiovascular death and all-cause death than those living with other people. “This should send up a little red flag that maybe this patient needs a little bit more attention,” said Dr. Deepak Bhatt, a researcher on the latter study. “Maybe we need to be a little more careful that this patient really does go to fill their prescription.” The findings appear in the Archives of Internal Medicine. (6/18),

About 4 in 10 Residential Care Facilities had one or more residents who had some or all of their long-term care services paid by Medicaid

Data from the 2010 National Survey of Residential Care Facilities

  In 2010, residential care facilities (RCFs) totaled 31,100, with 971,900 beds nationwide.
  About one-half of RCFs were small facilities with 4-10 beds. The remainder comprised medium facilities with 11-25 beds (16%), large facilities with 26-100 beds (28%), and extra large facilities with more than 100 beds (7%).
  One-tenth of all RCF residents lived in small RCFs and about that percentage (9%) lived in medium facilities, while the majority resided in large (52%) or extra large (29%) RCFs.
  About 4 in 10 RCFs had one or more residents who had some or all of their long-term care services paid by Medicaid.
  Larger RCFs were more likely than small RCFs to be chain-affiliated and to provide occupational therapy, physical therapy, social services counseling, and case management.

Source: NCHS Data Brief, Number 78, December 2011, National Center for Health Statistics,

Can for profits and not for profits mix when it comes to ACO’s?

Nursing home and hospital provider groups have asked the Internal Revenue Service for clarification and guidance regarding the participation of nonprofit providers in accountable care organizations. Many nonprofit groups are concerned that collaborating with for-profit partners will cause them to lose their exempt status, the Bureau of National Affairs reports.

Read more here:

New Long Term Care Plan

Editor’s note: As with so many things, it is all about the details. For example, as the government sought to close the drug benefit donut hole, they have opened another one. This time it is in the coverage for Long Term Care. Keep reading to discover that if you are 53 or older this plan will have little, if any, benefit for you.


Proponents of health care reform might consider President Obama’s signature on the historic law a class act, but advocates of long-term care (LTC) insurance are busy studying the literal translation of a key provision known by the same name.

A Kaiser Family Foundation comparative analysis of the Community Living Assistance Services and Supports (CLASS) Act noted that the legislative language remained unchanged between the House and Senate bills became the White House and congressional leadership reconciliation bill. Lawmakers have proposed a January 1, 2011 effective date for the voluntary public LTC insurance program, but several details still need to be ironed out.

So far, the proposal stipulates a daily cash benefit of no less than $50 after a five-year vesting period that would be paid for through payroll deductions. The plan would supplement traditional payers of LTC such as private insurance or Medicaid, helping people with functional limitations buy services needed to maintain personal and financial independence.

Jesse Slome, executive director of the American Association for Long-Term Care Insurance, says that while the CLASS Act could serve to spark enormous awareness of the LTC risks Americans face and the need to plan ahead, he fears that employers will wait to implement voluntary LTC plans until several critical areas are defined. 

“Because there is a five-year plan participation requirement, whatever benefits CLASS ultimately offers will really only have value for those employees who are currently age 53 or younger,” he explains. “As a result, a significant segment of American workers – those currently between 53 and 65 – will fall through the donut hole and fail to have long-term care protection.” 

Congress must decide on the cost to plan participants, benefit levels and requirements imposed on employers, which Slome says may not be available until 2012 and not applicable until the 2013 benefit plan year.